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From the lens of early-career researchers: bridging science, technology, arts, and humanities to tackle antimicrobial resistance
No full textAntimicrobial resistance (AMR) is a silent pandemic that presents a global challenge, urging researchers to develop innovative and transdisciplinary solutions. Our initiative aims to promote collaboration across science, engineering, economics, social sciences, and the arts to address the complex dimensions of AMR. We highlight the unique role of early-career researchers (ECRs) in advancing such cross-cutting approaches and conclude that empowering ECRs through equitable support and recognition is essential to sustaining innovation and mobilising communities against AMR
Biofilms of medical significance in and around humans
No full textMicrobial biofilm infections have become increasingly recognised as an important factor in human health, accounting for significant economic impacts. Beyond this, biofilms affect our lives more broadly, occupying a wide array of biological and abiotic surfaces associated with the human body. Biofilms are communities of cells, often interspecies (different bacteria) and interkingdom (including fungi and viruses), that are surface-attached sticky films and may or may not be visible to the naked eye. Beyond the human body, biofilms are often found on hospital equipment and the surrounding built environment. Moreover, water-associated surfaces in and around hospitals and the home environment represent the significant biofilm impact. The purpose of this review is to discuss the burden that biofilms place on the human body, either directly or indirectly, and to consider the impacts on the immunocompromised patient who may be exposed to biofilms on their person, in the hospital, and at home during their clinical journey.</p
Study on the relationship between lifetime and flow channel in proton exchange membrane fuel cells
No full textThe modification of flow channel shape in proton exchange membrane fuel cells (PEMFCs) has been shown to effectively enhance power density and overall performance. However, there remains a significant gap in understanding how these shape alterations affect the performance degradation of the membrane electrode assembly (MEA) and the underlying mechanisms. This study comprehensively considers key degradation factors of the MEA, including catalyst layer (CL) carbon corrosion, platinum (Pt) dissolution, sedimentation, oxidation, and proton exchange membrane (PEM) degradation mechanisms. Furthermore, we explore the structural changes induced by degradation and establish a three-dimensional performance mechanism model for PEMFCs based on these findings. Finally, we analyze the effects of varying flow channel widths on the MEA degradation mechanisms and their relationships with performance improvements. The study found that the established three-dimensional physical model for the performance degradation of PEMFCs fits the degradation process well during the 500 h simulation. Additionally, variations in channel width affect performance degradation; specifically, wider channels lead to more significant performance improvements. However, at a width of 1.4 mm, the rate of performance enhancement begins to slow down, while the degradation rate noticeably accelerates. When the width reaches 1.6 mm, the rate of carbon corrosion significantly increases, whereas at a width of 1.2 mm, the impact on the proton exchange membrane is minimal.</p
International Xenotransplantation Association (IXA) position paper on infectious disease considerations in xenotransplantation
No full textClinical xenotransplantation has the potential to address shortages of human organs for patients with end-stage organ failure. Advances in genetic engineering, immunosuppressive regimens, and infectious disease diagnostics have improved prospects for clinical xenotransplantation. Management of the infectious risks posed by clinical xenotransplantation requires biosecure breeding and validated methods for microbiological surveillance of source animals and recipients. Novel infection control protocols may complement biosafety requirements. Infectious risks in xenotransplantation include both known human pathogens common to immunosuppressed organ recipients and from porcine organisms or xenozoonoses for which the clinical manifestations are less well defined and for which microbial assays and therapies are more limited. Some pig-specific organisms do not infect human cells but have systemic manifestations when active within the xenograft. The human risk posed by porcine endogenous retroviruses (PERV) is uncertain. There are no documented transmissions of PERV in humans and swine are available with inactivated genomic PERV loci. Metagenomic sequencing will complement more traditional diagnostic tools in the detection of any unknown pathogens in xenotransplantation recipients. Such data are required for the development of protocols for donor and recipient microbiological surveillance, infection control, and antimicrobial therapies that will enhance the safety of clinical xenotransplantation.</p
Smart cities and ecological transport: challenges, prospects and impact on sustainable development
No full textThis research examines the challenges, prospects, and impact of integrating ecological transport systems in Ukraine within smart cities, with a focus on sustainable development. Urbanisation has led to significant environmental, economic, and social challenges, including increased traffic congestion, greenhouse gas emissions, and air quality deterioration. Traditional transportation systems often fail to address these issues effectively. The study explores the potential of environmentally friendly transport solutions, such as electric vehicles, hybrid cars, hydrogen-powered vehicles, and non-motorized transport, in mitigating these challenges. The research employs a comprehensive methodological approach, including SWOT analysis, to assess the strengths, weaknesses, opportunities, and threats of ecological transport systems in Ukraine, particularly in the context of ongoing military conflict and economic instability. The findings highlight the environmental benefits of reduced emissions, economic advantages like job creation and lower fuel costs, and social improvements in public health and transport accessibility. However, challenges such as insufficient infrastructure, economic instability, and the need for international support remain. The study concludes that integrating ecological transport into smart cities can significantly contribute to sustainable development, but requires targeted policies, infrastructure investment, and innovative technologies to overcome existing barriers.</p
Tailored implementation of national recommendations on falls prevention amongst older adults in municipalities in Norway—FALLPREVENT—a hybrid type 3 cluster-randomised trial
No full textBackground: Implementation of evidence-based falls prevention recommendations within community health care settings is variable and suboptimal. Objective: Evaluate the effectiveness of a tailored implementation strategy on adherence to falls prevention recommendations in Norwegian municipalities. Design: Hybrid type 3 cluster randomised trial. Participants: Twenty-five city districts/municipalities, with 13 intervention and 12 control clusters and 487 health care professionals (HCPs). Intervention: Clinical intervention: national recommendations for falls prevention for older adults. Tailored implementation strategy: leadership commitment, competence enhancement, resource teams and implementation support. Outcomes: Primary: self-reported adherence to the recommendations (questionnaire). Secondary: feasibility of the recommendations (Feasibility of Intervention Measure), experience of the implementation process (Normalisation Measure Development Questionnaire), fidelity to recommendations and strategy, and fall-related injuries. Assessments were conducted at baseline (T0), post-intervention at 9 months (T1) and at follow-up 15 months after baseline (T2). Results: HCPs adherence showed mean difference of 1.3 points (95% CI –0.2–2.9, P=.099) at T1 and 1.8 points (95% CI 0.2–3.5, P=.025) at T2, in favour of intervention versus control, along with higher scores on implementation experience at T2 (mean difference of 2.2 points; P=.033). No difference was found for feasibility or fall-related injuries. Fidelity to the recommendations was higher in the intervention clusters, for seminar attendance and implementation support. Conclusion A tailored strategy improved HCP reported adherence to and experience of implementing falls prevention recommendations. The limited effectiveness on clinical outcomes might be due to limited fidelity by HCPs in delivery of the falls prevention interventions or time needed to fully embed workforce wide implementation.</p
Machine learning-driven multiphase flow prediction for wet gas: a temporal data perspective incorporating fluid property analysis and explainable AI
Full text linkThe complexity and nonlinear behaviour inherent in multiphase flow systems make wet gas flow measurement a challenging aspect of monitoring and optimizing numerous production processes. Accurately determining phase flow rates with minimal uncertainty remains a critical challenge for operators. This study investigated the use of rapidly advancing technologies in industrial applications, focusing on eight machine learning (ML) and neural network (NN) algorithms to predict the gas and liquid flow rates. The prediction models were built by integrating the Venturi tube sensor temporal data and phase densities as primary features, in addition to adding a feature transform perspective. Furthermore, SHAP (SHapley Additive Explanations) and PFI (Permutation Feature Importance) analysis were used to enhance the model interpretability and transparency that leads to provide insights for the key feature's importance and aligning the results on model's performance. In terms of model performance, XGBoost, RF, and GRU consistently produced more accurate and stable output than the other models, with RF achieving a Mean Absolute Error (MAE) as low as 0.0012 for liquid flowrate and 0.0003 for gas flowrate, and XGBoost achieving an MAE of 0.0014 for liquid flowrate and 0.0003 for gas flowrate. While still the best-performing neural network, GRU's errors were slightly higher, with an MAE of 0.0266 for liquid and 0.0154 for gas. This study also provides insights into the application of data-driven techniques for the real-time monitoring of multiphase systems in field conditions and how the changing dynamics of flow would be challenging for AI-based solution methodologies to ensure accurate and robust measurements.</p
Recurrent care proceedings and use of services for substance use disorder: a retrospective linked data cohort study of mothers in South London
Full text linkBackground and aimsIn public family law cases (‘care proceedings’), many mothers return to proceedings after having a child removed. Substance use disorder (SUD) is a common feature in these cases. We used a linked dataset between SUD treatment services and family court to identify: i) the prevalence and estimated time for returning to care proceedings, ii) the characteristics of mothers who returned, and iii) differences in SUD treatment service use between mothers who returned to care proceedings and those who did not.DesignRetrospective study.SettingSouth London and Maudsley NHS Mental Health Trust (SLaM) catchment area, UK.Participants480 mothers involved in care proceedings with SUD between 2007 and 2019.MeasurementsSubstance use treatment records were linked to family court records. Kaplan Meier's time-to-event analysis was used to estimate the probability of returning to court and the recurrence rate. Hazard ratios (95% confidence intervals) were estimated to identify factors using Cox proportional regression analysis.FindingsFollowing the completion of the first care proceeding case, one-quarter of the cohort returned to proceedings (n = 119). Of returning mothers, 58.0% returned with a new baby and 52.0% had not received SUD treatment during the first proceedings. The risk of returning was highest within five years and was positively associated with younger maternal age [adjusted hazard ratio (aHR) 0.26, 95% confidence interval (CI) = 0.11–0.61], multiple children in initial proceedings (aHR 2.07, 95% CI = 1.36–3.18) and not receiving SUD treatment during initial proceedings (aHR 0.42, 95% CI = 0.29–0.61). The number of contact events with SUD treatment was not statistically significantly associated with returning to proceedings.ConclusionAmong mothers receiving treatment for substance use disorder and involved in care proceedings in England, nearly one in four were likely to appear in a subsequent care proceeding case
A cost–utility analysis of surgical site infection prevention: broadening the scope
No full textBackground: Surgical site infections (SSI) present a significant burden in terms of excess length of stay, distress, disability and death. SSI risk and the associated economic burden may be reduced through programmes of infection prevention and control (IPC) although evidence of their cost-effectiveness is limited. Patient-level data from the Evaluation of Cost of Nosocomial Infection (ECONI) study provided opportunity for analysis.Aim: The aim of this study is to explore the cost-effectiveness of enhanced SSI prevention in terms of costs and quality of life for adult surgical patients in the UK National Health Service (NHS).Methods: A Monte Carlo microsimulation model was built to evaluate the cost-effectiveness [cost per quality-adjusted life years (QALY)] of SSI prevention in three surgery types (coronary artery bypass graft, hip arthroplasty and caesarean section) by comparing an enhanced programme of SSI IPC to current clinical sequelae over 1 month and 1 year in the NHS. Uncertainty was explored through probabilistic sensitivity analysis, scenario analysis and the use of alternative utility valuation sets.Results: In most surgeries and time points, enhanced IPC was associated with lower costs and higher QALY gains than current SSI IPC measures. The results were sensitive to utility valuation methods used. Scenario analyses identified factors relating to SSI rate, IPC programme efficacy and cost resulted in strategy dominance changes over all three surgery types.Conclusions: Enhanced programmes of IPC for SSIs may deliver improved health outcomes at a lower cost; however, this is not consistent across all surgery types and timepoints and is sensitive to various factors
Brave new music: the Martyn Bennett story
Full text linkGary West. Edinburgh: Luath Press, 2025. 352 pp. Illustrations. ISBN: 978-1-804-25193-5 (hbk). 978-1-804-25211-6 (pbk)
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